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Background Several non-invasive technologies are nowadays available in the market which claim to determine the hemoglobin levels instantly without the requirement of the blood sample. But no study has shown the significance of such non-invasive devices on a routine basis for determining their impact on anemia reduction programs. This study is conducted to determine the impact of regular hemoglobin screening on the women population to determine its potential in reducing anemia, using a digitalized non-invasive device.Method A cross-sectional study was conducted on 203 women of reproductive age group, residing in the Moradabad district. Repetitive readings were taken after a time interval of a minimum of 1 month for determining the impact of regular screening. The entire data collection process was carried out using the EzeCheck mobile app.Results It was observed that the prevalence of anemia was reduced upon the second time screening and was accepted by the women population. Repetitive testing has a significant impact on reducing anemia prevalence. Also, the simplified non-invasive technology for estimating the hemoglobin values, makes the user more comfortable to take the test.Conclusion Non-invasive devices should be used regularly to keep track of hemoglobin levels which will help in the effective treatment of anemia. The mobile app-based testing could help to easily evaluate the reports of the patients from any remote location with instant result interpretation and health assistance.

Background: Oral squamous cell carcinoma (OSCC) accounts to the 6th most common cancer worldwide with high rate of mortality. Timely detection helps in improving the prognosis and survival rates. Deregulated expression of inhibitor of apoptotic (IAP) (programmed cell death) pathway mainly contributes to carcinogenesis by aberrantly extending cellular viability. Survivin is one such marker that belongs to the IAP protein family, expressed in tissue, serum, and other body fluids of patients with proliferating cells. The present study aimed to investigate survivin expression in salivary secretions of patients with various grades of OSCC. Methods: A total of 76 participants in the age range of 25–80 years were included in the study. Thirty eight histologically confirmed patients with various grades OSCC (well differentiated – 18, moderately differentiated – 10, and poorly differentiated – 10) and 38 healthy individuals were subjected to expectorate the unstimulated whole saliva. The salivary survivin estimation was performed using the Quantikine human enzyme-linked immunosorbent assay kit and comparisons were made. Results: The mean survivin levels were found to be statistically significant among OSCC and healthy individuals with much higher levels (9.51 pg/dl) observed in OSCC patients compared to healthy individuals (2.69 pg/ml). The levels of salivary survivin were found to be elevated in poorly differentiated (12.21 pg/ml) than moderately (9.80 pg/ml) and well-differentiated (7.84 pg/ml) OSCC patients. Conclusions: The study findings highlighted considerable increase in salivary survivin levels in different grades of OSCC patients as compared to healthy individuals.

Digital microfluidic biochip (DMFB) has attracted attention in the biochemical and medical industries. In particular, a microelectrode dot array (MEDA) biochip, which is composed of a two-dimensional microelectrode array, enables to realize fine-grained manipulation such as dilution, mixing, sensing, and so on in real-time. Unlike existing DMFB biochips, a MEDA architecture allows microelectrodes to control a certain volume of droplet in a fine-grained manner and can vary droplet volume and shape in such a way that it efficiently conducts synthesis and manipulation of droplets. There have been many works in order to improve the efficiency of synthesis of MEDA biochips; however, the synthesis, especially droplet routing, has never considered the shape-dependent velocity of droplets. In this paper, we propose the droplet routing techniques for MEDA biochips with shape-dependent velocity of droplets. The proposed techniques take the advantage of variant velocities of droplets dependent on the shapes and aim to reduce the overall routing time of a droplet from a source to a destination. Simulation results confirm that the proposed techniques can shorten the routing time by 80% compared to the state-of-the-art techniques.

Introduction: Lichen planus (LP) is a relatively common chronic, mucocutaneous disease of autoimmune origin, involves oral mucosa, skin, scalp, nails, and genital mucosa. The prevalence of oral LP (OLP) varies worldwide, commonly seen in middle-aged and elderly people. It usually presents as symmetrical and bilateral or multiple lesions with burning sensation (BS) sometimes accompanied by pain. Corticosteroids and calcineurin inhibitors have shown promising results in the treatment of OLP, but its chronic course and unpredictable exacerbations/remission continues to result in a high degree of morbidity. The study aimed to evaluate the efficacy of intralesional triamcinolone acetonide (injection TA) combined with topical application of TA orabase and Tacrolimus (TAC) ointment for symptomatic cases of OLP. Materials and Methods: The prospective study included 52 symptomatic OLP patients to receive (0.5 ml) intralesional injection of TA once a week for the first 4 weeks followed by one injection in the 6th week along with TA mucosal paste (0.1%.) and TAC ointment (0.03%) in tapering dose till 8th week. The subjective symptoms including BS and pain were assessed on a 10 cm visual analog scale (VAS) and objective signs like size and site of the lesion were scored according to criterion scale modified by Thongprasom et al. Differences were compared after 8 weeks treatment course and follow-up observations were performed at 20th week to record any recurrent lesion. Results: 41 patients (78.8%) had complete remission of disease and 11 (21%) had shown partial improvement. The VAS scores for BS and pain improved significantly. Improvement was also noted with decrease in the average size of active lesions and the number of sites with treatment. The relapse was seen in 17 patients (41%) in the 20th week. Conclusion: TA combined with TAC is a valuable therapeutic option for the treatment of symptomatic OLP. Our findings suggest that patients have shown statistically significant improvement.

A 46-year-old male reported to the Outpatient Department with the chief complaint of slow growing swelling in relation to upper front tooth region since one year. The swelling was gradual in onset with no history of pain, paresthesia or discharge. His personal history revealed that he was a cigarette smoker (4-5 times per day for 8 years), left his habit since a month. Medical history and family history were non contributory. The patient was moderately built with all vitals within normal limits. Extraoral examination showed the presence of diffuse, mobile, non tender swelling surrounded within the boundary of right nasolabial fold superiorly, vermillion border of upper lip inferiorly, right commissural area laterally and philtrum mesially. There was no regional lymphadenopathy noted and overlying skin was free with no evident change in colour and texture. Intraorally, well defined, single, firm, non tendered, non ulcerated swelling was noted in relation to 12, 13 and 14 resulting in the obliteration of the right maxillary labial vestibule. The swelling was dome shaped measuring 1.5×2 cm showing pale pink superficial mucosa with prominent vascular markings [Table/Fig-1]. Keeping the clinical features in view, the provisional diagnosis of benign salivary gland neoplasm was made. Differential diagnosis including fibroma, lipoma, canalicular adenoma, Pleomorphic Adenoma (PA) and abscess were considered. The excisional biopsy was performed under local anaesthesia after obtaining informed consent from the patient. The gross specimen comprised of an encapsulated soft tissue mass measuring 1.5×2×1.5 cm with rubbery consistency [Table/Fig-2]. The tissue sections were stained with Haematoxylin and Eosin (H&E) for microscopic evaluation showed the presence of thick capsule. Neoplastic glandular epithelial cells were arranged in the form of sheets with numerous ductal structures containing eosinophilic coagulum. The lumen of the ducts was lined by cuboidal cells surrounded by abluminal myoepithelial cells. Wide spread squamous metaplasia was observed with multiple cystic spaces filled with whorls of keratin. Few areas showed presence of plasmacytoid cells with eccentric nuclei and eosinophilic hyalinised cytoplasm [Table/Fig-3]. These microscopic features were suggestive of PA with extensive squamous metaplasia. The patient is under followup since two years and no recurrence is observed till date. Pleomorphic Adenoma (PA) is the most common benign salivary gland tumour that rarely involves minor salivary glands. The term PA was first described by Willis in 1953 to address diverse clinical and histological appearance of the tumour. The onset is usually reported in third to fourth decade with twice common female preponderance compared to the males. Total 50-60% cases are usually seen in the palate followed by upper lip (15-20%), buccal mucosa (8-10%) and tongue with few sporadic cases reported in maxillary sinus andpterygopalatine space. Benign tumours of salivary glands are six times more common in upper lip while malignant tumours have more frequency of occurrence on lower lip. Clinically, small lesions of the upper lip are asymptomatic, sessile, mobile rubbery mass with smooth surface. However, larger tumours are firm with bosselated appearance that may cause noticeable swelling with asymmetry of face [1-3]. In the present case, PA affecting upper lip was found in male patient in 4th decade with single, ovoid firm swelling with superficial vascular marking. Pleomorphic adenoma of minor salivary gland may present as well circumscribed, encapsulated mass but incomplete pseudocapsule or pseudopodia and extracapsular extensions are not rare in tumours with expansive growth. The acinar, ductal and myoepithelial cells are often arranged in ductal and cystic pattern undergoing aberrant metaplastic changes. The most classical feature is the presence of admixture of polygonal epithelial and spindle-shaped myoepithelial elements in a mucoid, myxoid, cartilaginous, or hyaline background stroma. Few plasmacytoid cells with eosinophilic cytoplasm and eccentrically placed nuclei may be present. Though, these cells are ectodermal in origin, yet smooth muscle expression is observed in the desmosomes, intermediate size filaments, endocytic vesicles, and microfilaments of myoepithelial cells [4]. The histopathology of present case showed the metaplastic squamous epithelium-lined cystic spaces containing numerous keratotic lamellae and some solid squamous cell islands with keratin whorls. Literature suggests that only 25% of PA may manifest squamous metaplasia posing considerable challenge in diagnosing such lesions. Ischaemia may induce epithelial morphogenesis in myoepithelial cells, thereby producing increased amounts of tonofilaments and desmosomes with loss of myofilaments at acinarintercalated duct cell complex [4,5]. Other neoplasms showing squamous differentiation include mucoepidermoid carcinoma, adenosquamous cell carcinoma, keratocystoma and conventional squamous cell carcinoma. However, absence of cellular and nuclear atypia, lack of invasion, minimal cellular activity with presence of intact fibrous capsule eliminates the diagnosis of malignancy [6]. The exact pathogenesis behind PA still remains controversial and has created a way for the researchers to intrude into the molecular level of genes. The complex process of morphogenesis of salivary gland is tightly regulated by growth molecules and transcription factors. The presence of chromosomal abnormalities due to translocation t(9;13)(p13;q12),) or reciprocal translocation t(9:12)(p13-21;q13- 15) related to PLAG1 are regarded as major responsible event that may cause homeostatic errors. Therefore, loss or alteration of these factors increases the probability of progression to malignant PA [2]. The treatment modality of PA arising from minor salivary glands was complete surgical excision with clear margins followed by uneventful healing.

Background: Implementing an active system to identify, monitor and manage risk from laboratory errors can enhance patient safety and quality of care. Aims and Objectives: Failure Mode and Effect Analysis (FMEA) technique allows evaluating and measuring the hazards of a process malfunction, to decide where to execute improvement actions, and to measure the outcome of those actions. The aim of this study was to assess pre analytical phase of laboratory testing, mitigate risk and thereby increase patient safety. Materials and Methods: Steps followed in the study were: planning the study, selecting team members, analysis of the processes, risk analysis, and developing a risk reduction protocol by incorporating corrective actions. A Fault Tree Analysis diagram was used to plot the cascade of faults leading to the pre analytical errors. Risk Priority Number (RPN) was assigned. A minimum cut- off 40 RPN was considered for interventions and highest RPN errors were prioritized with corrective actions. Post intervention RPN score was calculated. Results: Eight failure modes had the highest RPN. Corrective actions were prioritized against these errors. RPN scores of test ordering error, sample collection error, transport errors, error in patient identification, site selection, urine samples not received, sample accessioning and sample processing errors decreased, post intervention. Conclusion: With thorough planning, we can use FMEA as a common standard to analyze risk in pre analytical phase of laboratory testing.

The hypergeometric distribution has gained its importance in practice as it pertains to sampling without replacement from a finite population. It has been used to estimate the population size of rare species in ecology, discrete failure rate in reliability, fraction defective in quality control, and the number of initial faults present in software coding. Recently, Borges et al. considered a COM type generalization of the binomial distribution, called COM–Poisson–Binomial (CMPB) and investigated many of its characteristics and some interesting applications. In the same spirit, we develop here a generalization of the hypergeometric distribution, called the COM–hypergeometric distribution. We discuss many of its characteristics such as the limiting forms, the over- and underdispersion, and the behavior of its failure rate. We write its probability-generating function (pgf) in the form of Kemp’s family of distributions when the newly introduced shape parameter is a positive integer. In this form, closed-form expressions are derived for its mean and variance. Finally, we develop statistical inference procedures for the model parameters and illustrate the results by extensive Monte Carlo simulations.

Cloud computing is one of the most popular and pragmatic topics of research nowadays. The allocation of cloudlet(s) to suitable VM(s) is one of the most challenging areas of research in the domain of cloud computing. This paper highlights a new cloudlet allocation algorithm which improves the performance of a cloud service provider (CSP) in comparison with the other existing cloudlet allocation algorithms. The proposed Range wise Busy-checking 2-way Balanced (RB2B) cloudlet allocation algorithm optimizes few basic parameters associated with the performance analysis. An extensive simulation is done to evaluate the proposed algorithm using Cloudsim to attest its efficacy in comparison to the other existing allocation policies.

Clear cell odontogenic carcinoma is a rare, aggressive neoplasm of the jaw with only 74 reported cases. It occurs predominantly in the mandibular anterior region during fifth to seventh decades of life. Clinically it manifests as intra-bony swelling with a variable degree of pain. Microscopically, it reveals nests of cells with clear cytoplasm in connective tissue stroma arranged in different patterns. It is often misdiagnosed due to the rarity of lesion and confusing histopathology. Immunohistochemical staining plays an intricate role to uncertain the native of the clear cell to reach a confirmative diagnosis. The article aims to highlight the clinicopathologic features of clear cell odontogenic carcinoma in a middle-aged man with special emphasis on its differential diagnosis.

This paper deals with the effect of different size gold nanoparticles on the fluidity of lipid membrane at different regions of the bilayer. To investigate this, we have considered significantly large bilayer leaflets and incorporated only one nanoparticle each time, which was subjected to all atomistic molecular dynamics simulations. We have observed that, lipid molecules located near to the gold nanoparticle interact directly with it, which results in deformation of lipid structure and slower dynamics of lipid molecules. However, lipid molecules far away from the interaction site of the nanoparticle get perturbed, which gives rise to increase in local ordering of the lipid domains and decrease in fluidity. The bilayer thickness and area per head group in this region also get altered. Similar trend, but with different magnitude is also observed when different size nanoparticle interact with the bilayer.

Background: Several non-invasive technologies are nowadays available in the market which claim to determine the hemoglobin levels instantly without the requirement of the blood sample. But no study has shown the significance of such non-invasive devices on a routine basis for determining their impact on anemia reduction programs. This study is conducted to determine the impact of regular hemoglobin screening on the women population to determine its potential in reducing anemia, using a digitalized non-invasive device. Method: A cross-sectional study was conducted on 203 women of reproductive age group, residing in the Moradabad district. Repetitive readings were taken after a time interval of a minimum of 1 month for determining the impact of regular screening. The entire data collection process was carried out using the EzeCheck mobile app. Results: It was observed that the prevalence of anemia was reduced upon the second time screening and was accepted by the women population. Repetitive testing has a significant impact on reducing anemia prevalence. Also, the simplified non-invasive technology for estimating the hemoglobin values, makes the user more comfortable to take the test. Conclusion: Non-invasive devices should be used regularly to keep track of hemoglobin levels which will help in the effective treatment of anemia. The mobile app-based testing could help to easily evaluate the reports of the patients from any remote location with instant result interpretation and health assistance. [ABSTRACT FROM AUTHOR]